Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09817 | Date 27/08/2025 |
| Token No | SM/25-26/6993 28/08/2025 | Serial | 002 |
| Patient Name | Mrs. MAHAMAYA BASAK | Contact No | 9339982528 |
| Address | 97 1NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 52 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||